Lifetime risk of prostate cancer overdiagnosis in Australia: quantifying the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.
BMJ Open
; 9(3): e022457, 2019 03 10.
Article
em En
| MEDLINE
| ID: mdl-30858156
ABSTRACT
OBJECTIVES:
To quantify the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.DESIGN:
Modelling and validation of the lifetime risk method using publicly available population data.SETTING:
Opportunistic screening for prostate cancer in the Australian population.PARTICIPANTS:
Australian male population (1982-2012).INTERVENTIONS:
Prostate-specific antigen testing for prostate cancer screening. PRIMARY AND SECONDARY OUTCOMEMEASURES:
Primary lifetime risk of overdiagnosis in 2012 (excess lifetime cancer risk adjusted for changing competing mortality); Secondary lifetime risk of prostate cancer diagnosis (unadjusted and adjusted for competing mortality); Excess lifetime risk of prostate cancer diagnosis (for all years subsequent to 1982).RESULTS:
The lifetime risk of being diagnosed with prostate cancer increased from 6.1% in 1982 (1 in 17) to 19.6% in 2012 (1 in 5). Using 2012 competing mortality rates, the lifetime risk in 1982 was 11.5% (95% CI 11.0% to 12.0%). The excess lifetime risk of prostate cancer in 2012 (adjusted for changing competing mortality) was 8.2% (95% CI 7.6% to 8.7%) (1 in 13). This corresponds to 41% of prostate cancers being overdiagnosed.CONCLUSIONS:
Our estimated rate of overdiagnosis is in agreement with estimates using other methods. This method may be used without the need to adjust for lead times. If annual (cross-sectional) data are used, then it may give valid estimates of overdiagnosis once screening has been established long enough for the benefits from the early detection of non-overdiagnosed cancer at a younger age to be realised in older age groups.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Risco
/
Antígeno Prostático Específico
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Detecção Precoce de Câncer
/
Uso Excessivo dos Serviços de Saúde
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adult
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Aged
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Aged80
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Humans
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Male
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Middle aged
País/Região como assunto:
Oceania
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article